Where’s that stethoscope? A survey of psychiatrists’ attitudes to their role in managing physical health

Greenstone, Harriet; Burlingham, Amy

doi:10.1108/jmhtep-10-2019-0056

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Mental health teams may also undertake clinical activities outside of their core expertise. 54 Where a service user is reluctant to engage with their GP, psychiatrists and nursing staff have reported performing and interpreting physical healthcare investigations, such as phlebotomy and electrocardiograms, despite acknowledging their lack of confidence in carrying out these tasks. 53 In these circumstances, one must consider whether imperfect test result interpretation is preferable to the absence of such investigations.…”

Section: Resultsmentioning

confidence: 99%

“…Mental health teams may also undertake clinical activities outside of their core expertise (Greenstone & Burlingham, 2020). Where a service user is reluctant to engage with their GP, psychiatrists and nursing staff have reported performing and interpreting physical healthcare investigations, such as phlebotomy and electrocardiograms (ECGs), despite acknowledging their lack of confidence in carrying out these tasks (NHS England, 2016).…”

Section: Locating the Boundaries Of The Phenomenon Of Interestmentioning

confidence: 99%

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Conceptual and practical challenges associated with understanding patient safety within community‐based mental health services

Averill

Vincent

Reen

et al. 2022

Health Expectations

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Patient safety problems stemming from healthcare delivery constitute a global public health concern and represent a pervasive barrier to improving care quality and clinical outcomes.However, evidence generation into safety in mental healthcare, particularly regarding community-based mental health services, has long fallen behind that of physical healthcare, forming the focus of fewer research publications, and developed largely in isolation from the wider improvement science discipline. We argue that this disconnect yields, and is likely the product of, both conceptual and practical difficulties which must be overcome to advance the science and improvement of safety in mental health services. Drawing upon theoretical and empirical evidence from the fields of mental healthcare, patient safety, and improvement science, challenges encountered in our efforts to understand patient safety problems in community-based mental health services, a particularly unmapped area of safety, are described. We consider the origins of these issues and their probable implications for patient safety science and clinical care. Challenges in defining safety in the context of community mental healthcare, establishing what constitutes a 'preventable' safety problem, and the available evidence, are outlined. The dominant risk management approach to safety in mental healthcare, which positions service users as the origin of risk, has seemingly prevented a focus on proactive safety promotion, considering iatrogenic harm and latent system hazards. We propose a wider conceptualisation of safety and discuss important next steps for the integration and mobilisation of disparate sources of 'safety intelligence', to advance how safety is conceived and addressed within community mental healthcare.

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Section: Resultsmentioning

confidence: 99%

Section: Locating the Boundaries Of The Phenomenon Of Interestmentioning

confidence: 99%

Conceptual and practical challenges associated with understanding patient safety within community‐based mental health services

Averill

Vincent

Reen

et al. 2022

Health Expectations

View full text Add to dashboard Cite

show abstract

“…Physical examination skills form a core competency set in practising psychiatrists (Kick et al 1997). However, many doctors believe their physical examination skills to have deteriorated since specialising in psychiatry (Greenstone & Burlingham, 2020). This study set out to assess the confidence levels of practising psychiatrists in physical healthcare competencies through a cross-sectional survey in one Irish region, and to explore availability of learning opportunities.…”

Section: Introductionmentioning

confidence: 99%

Psychiatrists and physical health competencies: a cross-sectional survey

O’Donnell

Pradeep²,

Dunne

et al. 2021

Ir. j. psychol. Med.

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Medication management and electrocardiogram screening in children with attention deficit hyperactivity disorder

Pentony,

Ali,

Moore

et al. 2024

Cardiol Young

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Background: To quantify the proportion of referrals sent to Crumlin Cardiology Department for cardiac screening prior to commencement or modifying attention deficit hyperactivity disorder medication and assess the number detected with a clinically significant abnormality. Methods: A prospective audit was performed over a 6-month period, from November 2021 to April 2022 inclusive. Referrals sent via outpatient department triage letters, electrocardiogram dept. email, and walk-in electrocardiogram service were screened for those pertaining to commencing or modifying medication for children with attention deficit hyperactivity disorder. Each referral was coded against National Institute for Health and Care Excellence guidelines to determine the degree of clinical details given. Reported abnormalities, recommended management, and correspondence were recorded. Results: Ninety-one referrals were received during the 6-month audit period. More than half lacked a clinical indication for referral (53/91, 58.2%), with fewer than one third (26/91, 28.5%) meeting National Institute for Health and Care Excellence criteria for referral for cardiology. Eighty (80/91) referrals had clinical outcomes available for review (missing outpatient department information and age outside of service range accounted for eleven referrals with unavailable clinical outcomes). Of the eighty clinically reviewed referrals, seventy-two (72/80, 90%) were reported as normal with no cardiology follow up required. Eight referrals (8/80, 10%) were reviewed in the Cardiology Outpatient Department prior to commencement or modifying attention deficit hyperactivity disorder medication. Of these, only one (1/80 1%) had a clinically significant abnormality which was a potential contraindication to attention deficit hyperactivity disorder medication use, and this referral was appropriate as per National Institute for Health and Care Excellence guidelines. Conclusion: Routine screening prior to attention deficit hyperactivity disorder medication prescription in the absence of clinical indications (as per National Institute for Health and Care Excellence) contributed to delays in medication initiation among young people with attention deficit hyperactivity disorder. Unnecessary referrals have resource implications for cardiology clinical team. Improved adherence to National Institute for Health and Care Excellence guidelines would provide benefits for patients and clinicians.

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Where’s that stethoscope? A survey of psychiatrists’ attitudes to their role in managing physical health

Cited by 3 publications

References 17 publications

Conceptual and practical challenges associated with understanding patient safety within community‐based mental health services

Conceptual and practical challenges associated with understanding patient safety within community‐based mental health services

Psychiatrists and physical health competencies: a cross-sectional survey

Medication management and electrocardiogram screening in children with attention deficit hyperactivity disorder

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